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一例腿部溃疡患者的不寻常表现:病例报告

An Unusual Presentation of a Patient with Leg Ulcers: A Case Report.

作者信息

Zafar Sana, Saleem Khurram, Rashid Aqeela

机构信息

Internal Medicine, University College of Medicine, University of Lahore, Lahore, PAK.

Internal Medicine, Jinnah Hospital, Allama Iqbal Medical College, Lahore, PAK.

出版信息

Cureus. 2019 Dec 5;11(12):e6293. doi: 10.7759/cureus.6293.

Abstract

Leg ulcers have been a common presentation in clinics; disruptions in the mechanism of ulcer healing are vascular insufficiency, anemia, metabolic disturbances, neuropathy, and autoimmunity. The term 'non-transfusion-dependent thalassemia' encompasses the milder forms of thalassemia traits that require intermittent or no transfusion at all, and are mostly associated with leg ulcers. We present the case of a 19-year-old female with beta-thalassemia major who presented with non-healing leg ulcers and anemia. The clinical findings and lab evidence suggested hemolytic anemia evidenced by pathologic fractures, hepato-splenomegaly, and normal iron studies. Hemoglobin electrophoresis confirmed beta-thalassemia major with its complications including adrenal insufficiency and pathological fractures, all of which remained well compensated till the second decade of life.

摘要

腿部溃疡一直是临床上常见的病症;溃疡愈合机制的破坏包括血管功能不全、贫血、代谢紊乱、神经病变和自身免疫。“非输血依赖型地中海贫血”一词涵盖了症状较轻的地中海贫血特征类型,这些类型需要间歇性输血或根本不需要输血,且大多与腿部溃疡有关。我们报告一例19岁重型β地中海贫血女性患者,该患者出现了不愈合的腿部溃疡和贫血。临床检查结果和实验室证据提示为溶血性贫血,表现为病理性骨折、肝脾肿大以及铁代谢检查结果正常。血红蛋白电泳确诊为重型β地中海贫血及其并发症,包括肾上腺功能不全和病理性骨折,所有这些在患者生命的第二个十年之前都得到了很好的代偿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/892b/6942503/efaccf4015a3/cureus-0011-00000006293-i01.jpg

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